The outbreak of the novel coronavirus has presented an opportune moment for South Africa to move with speed on the implementation of the National Health Insurance (NHI).
The failures of the two-tier healthcare system have been laid bare for all to see. The narration has always been that the private healthcare system offers the best medical attention there is. This misleading narrative has been dispelled by the many fumbles of private healthcare providers that have led to the infection of many frontline workers at Morningside Mediclinic, Netcare St Augustine’s, Kingsway and Pholoso in Polokwane.
This takes places while the private sector spends 4.4% of GDP, which only benefits 16% of the population. The public sector spends 4.1% of GDP on the remaining 84% of the population. Currently and historically the private sector has benefited more from government while the public health system has been neglected for many decades.
The private healthcare system has taken advantage of the poor quality of public health care to impose extortionate charges, which have led to the suffering of poor sick people and catastrophic impoverishment of scores of working class households.
The NHI seeks to correct the deeply entrenched inequalities in our healthcare system. In this regard, massive resources are still needed if we are to accelerate the implementation of the NHI, which necessitates that government collapses the two-tier system into one that will serve people based on their illnesses and not based on the size of their pockets.
While the announcement that government over the medium term will reprioritise R55.6 million to the department of health to strengthen its capacity to phase in NHI is welcomed, more funding can be sourced from present government healthcare funding, funds that government spends on tax subsidies for medical aid members, contributions from people who are presently members of medical aids, and contributions from those earn well but resort to not joining medical aids.
Moreover, through low administrative costs and high efficiency from healthcare providers, the NHI will become the success it is destined to be.
The implementation of the NHI should go hand in hand with the transformation of our healthcare system and the realisation of universal health coverage. This requires an active citizenry that is mobilised behind the ideals of the NHI and the first attack must be aggressively directed against the rising cost in private health care by profit-seeking service providers.
A clarion call must be made to parliament to move with speed to enact the NHI Bill as an act of parliament for implementation to take place as a matter of urgency. Our parliament must not bow to pressure from detractors of the NHI (which includes big hospital groups, medical aid companies, AfriForum and the Democratic Alliance) who are profit driven but rather prioritise the health care of our people.
As part of the manifesto commitments made by the African National Congress for the 2019 national general elections, the NHI took centre stage in canvassing for votes, and it is about the time the governing party rewards its loyal supporters.
Khaya Xaba is the national spokesperson of trade union NEHAWU, which is deeply involved in the health sector